Most women develop their own unique relationship with their bowel movements over time. You get to know your body's patterns so well that you can predict exactly which situations will trigger a bathroom visit — like that one store that makes you beeline for the bathroom as soon as you walk in, or the love-hate relationship between you and coffee first thing in the morning. But when you start experiencing irregular bowel patterns that could signal IBS (irritable bowel syndrome), that relationship becomes more complicated.

According to research from the American College of Gastroenterology, approximately 5% of people in the US struggle with IBS, with studies showing it affects women more frequently than men. While IBS can be triggered by various factors including stress, diet, and environmental changes, women face additional challenges as their menstrual cycles can significantly impact symptoms.

“Studies suggest that there is more diarrhea during the menstrual phase and more constipation during the luteal phase,” explains gastroenterologist expert, Dr. Asma Khapra.

Specifically, increased progesterone during the luteal phase can slow gut motility, which causes more constipation, while increased estrogen levels during the follicular phase do the opposite and make diarrhea more common for those who struggle with IBS.

Whether you know you have IBS or are curious if your hormones or diets are the culprits behind your rollercoaster bathroom visits, here’s what to know for your next doctor visit.

woman with ibs clutching her lower abdomen in pain

Symptoms of IBS in women

We mentioned diarrhea and constipation, but there are actually three other symptoms that are common for those who struggle with IBS. According to Dr. Khapra (and many other studies), those include abdominal pain, bloating, and an urgency to go to the bathroom.

But that’s unfortunately not all — IBS in women can also cause:

  • Mucus in stools
  • Increased fatigue and sleep disturbances
  • More frequent headaches or migraines
  • Greater sensitivity to certain foods
  • Bladder problems
  • Painful intercourse
  • Back pain

(Think you might have IBS? Take our quiz to find out and get the answers you need.)

Causes of IBS in women

While researchers haven't pinpointed an exact cause of IBS, they believe several factors work together to trigger the condition, especially in women:

  • Brain-gut link: As your brain reacts to emotional and physical triggers, your gut does, too.
  • Hormonal influences: The female digestive tract contains receptors for estrogen and progesterone throughout. These hormones can affect how the gut functions, which helps explain why many women notice their symptoms change during different phases of their menstrual cycle.
  • Stress response: Difficult life experiences or ongoing stress can affect how your digestive system functions. Research shows that women may process stress differently than men, potentially contributing to their higher rates of IBS.
  • Bacterial changes: Some women develop IBS after a digestive tract infection or experience changes in their gut bacteria (microbiome). These changes can affect how the digestive system works and processes food.
  • Food sensitivities: Many women with IBS find that certain foods trigger their symptoms. While these aren't true allergies, the digestive system may react more sensitively to specific foods, especially during hormonal changes.
  • Genetic factors: Research suggests that genetics may make some people more susceptible to developing IBS, though this connection is still being studied.
  • Mental health: Conditions like anxiety and depression can influence gut function through the brain-gut connection. However, it's important to understand that while stress and emotional factors can trigger symptoms, IBS is a real physical condition — not something that's "all in your head."

two people conversing over coffee

IBS during period

Many women notice their IBS symptoms intensify during their menstrual cycle, particularly during menstruation. Studies show that hormonal fluctuations play a significant role in this connection.

During the luteal phase (before menstruation), increased progesterone levels can slow gut motility, often leading to constipation. When menstruation begins and hormone levels drop, many women experience increased diarrhea, more frequent abdominal pain, greater bloating, enhanced sensitivity to trigger foods, and more intense cramping (sorry!).

To manage these symptoms effectively, tracking both your menstrual cycle and IBS symptoms can help identify patterns and prepare for potential flare-ups.

Can IBS cause a missed period?

While IBS itself doesn't directly cause missed periods, the relationship between these conditions is complex and interconnected. IBS doesn't interfere with the basic hormonal processes that regulate menstruation, but the stress of managing chronic IBS symptoms can affect your menstrual cycle.

Some women notice changes in their menstrual patterns during severe IBS flares, though this is typically related to the overall stress on the body rather than IBS directly. The same hormonal imbalances that might cause irregular periods can also trigger or worsen IBS symptoms, creating what can feel like a challenging cycle.

If you experience irregular periods, it's important to consult with your healthcare provider to rule out other underlying conditions, as this symptom could be related to various factors beyond IBS.

 

woman explaining her ibs symptoms to her doctor

What should I do if I think I have IBS?

If you suspect you might have IBS, the first step is understanding that effective treatment and support are available. According to Dr. Khapra, "The current guidelines suggest that a combined and holistic approach to treatment is the best way to address IBS — this includes diet modifications, medications, exercise/stress reduction techniques, along with cognitive behavioral therapy (CBT) and/or gut hypnosis and generally avoiding triggers."

Before seeing a doctor, you can start by keeping track of your symptoms and potential triggers. "First I evaluate [your] diet to see if there are any triggers," suggests Dr. Khapra. "Avoid some of the obvious dietary triggers — dairy, processed foods, sugars, caffeine (especially for diarrhea). Decrease stress and increase exercise, yoga, and mindfulness. See if there are any obvious hormonal triggers and associations with the menstrual cycle. Improve sleep."

When you're ready to seek professional help, your healthcare provider will use established criteria from the Rome IV Foundation to evaluate your symptoms and determine if you have IBS. According to Dr. Khapra, they'll look for changes in things like the frequency and consistency of your stool. Your doctor may also recommend additional tests for conditions like celiac disease, SIBO (small intestinal bacterial overgrowth), and thyroid disease to rule out other potential causes of your symptoms.

There are three main types of IBS that your doctor will consider:

  • IBS-C (IBS with constipation)
  • IBS-D (IBS with diarrhea)
  • IBS-Mixed (IBS with a mix of constipation and diarrhea)

Taking time to self-assess and track your symptoms before your appointment will help provide your healthcare team with valuable information to determine the best treatment approach for your specific situation.

woman smiling

Living with IBS can feel overwhelming, but it's crucial to remember that your symptoms are real and valid — not just "in your head." Modern medicine has made significant strides in understanding and treating this condition. As Dr. Khapra explains, "In the last 10 years, there have been great advances in IBS, multiple medications, diets, and holistic treatments that can be effective. Prescription medications are available for both flares and long-term control of IBS."

The key to managing IBS effectively is working with healthcare providers who understand the unique challenges women face, particularly how hormonal cycles can influence symptoms. Keep a detailed record of your symptoms, triggers, and patterns — especially how they relate to your menstrual cycle. This information will help your healthcare team develop a personalized management plan that addresses both your digestive and hormonal health.

Remember, while the path to managing IBS may take time, there are more treatment options available than ever before. With the right support and management strategy, you can work toward reducing the impact of IBS on your daily life and overall wellbeing.


​​Vivian Nunez is a writer, content creator, and host of Happy To Be Here podcast. Her award-winning Instagram community has created pathways for speaking on traditionally taboo topics, like mental health and grief. You can find Vivian @vivnunez on Instagram/TikTok and her writing on both Medium and her blog, vivnunez.com.

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